Individual
DR. DAVID ETHAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7130 VILLAGE MEDICAL CIR, CLEMMONS, NC 27012-8004
(336) 893-2420
(336) 893-2431
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 712-0700
(336) 712-0876
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006-00237
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904219
—
NC
Enumeration date
05/05/2006
Last updated
10/28/2020
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